Heel stick on side of foot/medial ankle

[beautifulbyHisblood]

Hey there! Wouldn't you believe it, another question about heel sticks! :)

Last night I had a kiddo that I needed a blood sugar sample from. She had a right club foot and that was the foot I was using for the test, so her foot curved outward, making it harder to differentiate between the foot and the medial ankle. I cleaned the area and the mom counted to 3, so I placed the lancet on the medial periphery of the foot pad and clicked the lancet. Blood came, but it looked like it nicked higher up than I had planned. When I put the band-aid on, it looked like the lancet had punctured a little bit above the foot pad and more like the side of the foot. The baby stopped bleeding and all was well, but I keep reading stuff about osteomyelitis and it's scaring me half to death! I know that's mostly if you stick right in the middle of the heel, but still?!

Please help put my mind at ease...

[Jolie, BSN]

I would not recommend doing a heel stick on a foot with a significant deformity, for the reasons you describe.

Was the other heel not accessible? How old was the child? Perhaps a finger stick would have been an option?

[KelRN215, BSN, RN]

In the future, I would use the foot without the deformity, a toe or an finger. Any of the above are acceptable for a glucose. I don't think I've ever done a heel stick just for glucose... finger or toe will give you a sufficient sample.

[Jory, MSN, APRN, CNM]

I too, would not use the heel with the deformity, but would use the other foot.

I have never seen a nurse use a finger on an infant for glucose, but the big toe..sometimes.

I started using lancets made for premies if I had only a glucose to take...they made a smaller prick...I figured this out the hard way when I had to use the lancet on myself...was ridiculously painful.

[nola1202]

Excellent advice from all the other posts, just wanted to address your anxiety. Thankfully, 99.9% of our less than stellar interventions have no adverse effects. You are learning and that's what's important. I notice with the square lancets for heel sticks, the actual stick is a little higher than I anticipated it would be. I've learned to correct for that with experience. I also lol about getting stuck with a lancet...me too! youch!

Rest easy, and keep asking questions, reading and learning from experience.